Effect of Whole Body Horizontal Vibration Exercise in Chronic Low Back Pain Patients: Vertical Versus Horizontal Vibration Exercise

Abstract

Objective: To elucidate the effect of a 12-week horizontal vibration exercise (HVE) in chronic low back pain (CLBP) patients as compared to vertical vibration exercise (VVE).

Methods: Twenty-eight CLBP patients were randomly assigned to either the HVE or VVE group. All participants performed the exercise for 30 minutes each day, three times a week, for a total of 12 weeks. Altered pain and functional ability were evaluated using the visual analog scale (VAS) and Oswestry Disability Index (ODI), respectively. Changes in lumbar muscle strength, transverse abdominis (TrA) and multifidus muscle thicknesses, and standing balance were measured using an isokinetic dynamometer, ultrasonography, and balance parameters, respectively. These assessments were evaluated prior to treatment, 6 weeks and 12 weeks after the first treatment, and 4 weeks after the end of treatment (that is, 16 weeks after the first treatment).

Results: According to the repeated-measures analysis of variance, there were significant improvements with time on VAS, ODI, standing balance score, lumbar flexor, and extensor muscle strength (all p<0.001 in both groups) without any significant changes in TrA (p=0.153 in HVE, p=0.561 in VVE group) or multifidus (p=0.737 in HVE, p=0.380 in VVE group) muscle thickness. Further, there were no significant differences between groups according to time in any of the assessments. No adverse events were noticed during treatment in either group.

Conclusion: HVE is as effective as VVE in reducing pain, strengthening the lumbar muscle, and improving the balance and functional abilities of CLBP patients. Vibrational exercise increases muscle strength without inducing muscle hypertrophy.

Keywords: Balance; Low back pain; Muscle strength; Vibration; Visual analog scale.

Fig. 1.

A participant stands on the vibrating platform of horizontal whole-body vibration (EXXTREAM 1000) with flexions of both knees.

Fig. 2.

Comparison between horizontal vibration exercise (HVE) and vertical vibration exercise (VVE) groups. (A) Visual analog scale, (B) Oswestry disability index, (C) lumbar flexor peak torque, (D) lumbar flexor average power, (E) lumbar extensor peak torque, (F) lumbar extensor average power, (G) transverse abdominis, (H) multifidus, (I) anteroposterior index, and (J) medio-lateral index. All variables except for muscle thickness were significantly changed according to time in each group; however, no variables with significant time-group interactions between the groups existed. All results were obtained using repeated-measures of ANOVA. Ho, horizontal vibration group; Ve, vertical vibration group; t0, assessment at baseline; t1, assessment at 6 weeks; t2, assessment at 12 weeks; t3, assessment performed after 4 weeks from the end of intervention. *p<0.05, a significant difference according to time in each group (solid line, difference in horizontal vibration exercise group; dotted line, difference in vertical vibration exercise group.